Two locations to choose from: 1000 Galloping Hill Rd #202, Union, NJ 07083 | 654 Broadway, Bayonne, NJ 07002
TOTAL KNEE REPLACEMENT
The knee is a weight bearing joint that you use with every step you take. It is made of the lower end of the thigh bone (femur) and the upper end of the shin bone (tibia).
The Knee Joint
The knee is a weight bearing joint that you use with every step you take. It is made of the lower end of the thigh bone (femur) and the upper end of the shin bone (tibia). These two bones do not come directly in contact with each other but are separated by cartilage that forms a cushion between the bones. Dense cords and bands of tissue called ligaments hold the two bones in place. The knee cap (patella) forms an anchor for attachment of the quadriceps muscle in the front of the thigh. A tendon, composed of tissue that is tough like a ligament, extends from the quadriceps muscle and patella and is connected to the tibia.
Arthritis of the Knee
Diseases that primarily damage joints are known as arthritis. One of the most common types of arthritis that requires knee replacement is osteoarthitis. This results from years of ordinary use that wear away the coating of smooth cartilage that covers the ends of the bones inside the knee joint. First the cartilage becomes rough and then it is gradually but completely worn away in areas where there is the most friction. Pain occurs when bones come directly in contact with each other where there is no more cartilage. Nodules of cartilage pile up at the edges of the joint where there is little friction. Traumatic arthritis is similar to osteoarthitis but the wear and tear is accelerated because of previous injury to the knee joint which did not heal properly. Other forms of arthritis that can damage the knee joint include gout and rheumatoid arthritis. These conditions also destroy the cartilage and result in pain and difficulty in movement.
Diagnosis of Your Knee Problem
During your visit, we will ask you where you feel pain and for how long you have had it. We also need to know if you have ever injured your knee recently or in the past, and whether you have any other problems that may impact your treatment such as diabetes, high blood pressure, previously diagnosed arthritis, bleeding disorders, or sensitivity to anesthesia. You should also tell us of any medications you are currently taking since some of these, like aspirin, ibuprofen, and blood thinners may cause bleeding if you have surgery. We will examine your knee for its range of motion, strength and stability, and the condition of the surrounding muscles, tendons, and nerves. X-rays will help us determine the size, shape and condition of the bones of your knee. We can tell if there are bony projections (spurs), cysts, or pitting. You may require other types of tests such as an EKG (electrocardiogram) and blood tests. We will use the results of the examination and tests to determine what type of treatment is best for your knee problem. Although other measures like medications and knee arthroscopy may be helpful, the best solution may be replacement of the affected knee with an artificial joint, or prosthesis. An artificial knee joint can help you return to many of your routine activities.
Before the day of surgery arrives you should take care of a number of things. Considering that you will have some difficulty moving immediately after surgery, you should arrange to have someone drive you home after surgery and help you with household errands for several weeks after surgery. Arrange items at home - set up your sleeping area where you can limit the number of times you have to use the stairs, store a generous amount of non-perishable food (canned, frozen, and dried) and keep it at an easily reachable level, remove small rugs and tape down electrical cords to prevent falls. Have dental work completed before surgery so that germs from your mouth do not infect your prosthesis. Donate blood for yourself (autologous donation) to be used to replace blood lost during surgery. If necessary, tested blood from other donors can usually be obtained from the hospital's blood bank. Ask us if and when you should stop taking medications which might cause bleeding problems during surgery.
You will generally be told not to eat or drink anything after midnight the night before surgery. When you come to the hospital, which will usually be on the day of surgery, you will speak with your anesthesiologist (a doctor specializing in anesthesia) regarding which type of anesthesia will be best for you - whether you should sleep through the operation or be numbed from the waist down. Your vital signs (pulse, blood pressure, temperature, and breathing) will be checked and you may be given an IV (intravenous) line if fluids need to be given through a vein.
At surgery, an incision measuring about 8 to 10 inches long will be made either on the front or side of your knee. We will remove bone from the lower end of your femur and the upper end of your tibia so we have flat surfaces to fasten your new prosthesis. The X-rays that were taken of your knee help us to place the different parts of the prosthesis in the right locations. Once we are satisfied that the prosthesis fits properly we will secure it in place. When we are finished with the knee replacement and are ready to close the incision, a tube may be inserted to drain excess fluid. The diseased bone and tissues that we remove are sent to the pathology department for examination.
Although knee replacement is generally a safe procedure, sometimes complications occur. These complications may include infection, blood clots in your legs, damage to the muscles, blood vessels, and nerves around the knee, and dislocation of the knee cap.
After surgery you will be moved to the recovery room where your condition will be closely watched until your anesthesia wears off. At this time you will be given medication to control pain and you may also be given a catheter to drain urine from your bladder. A CPM (continuous passive motion) machine may be used to move your knee so that it does not become stiff. Afterwards you will be moved from the recovery room to your hospital room where condition will continue to be watched. Your pain medications will also continue. Special stockings may be applied to prevent blood clots from forming in your legs. To prevent pneumonia, you should cough frequently and take deep breaths. This clears your lungs of fluid that has accumulated during surgery. If your bed has a bar or trapeze attachment hanging over it, you can use it to pull yourself up when you want to change positions. Although the CPM machine can help keep you from getting stiff, you will soon have to learn to move on you.r own. You should be able to stand and walk with assistance within hours of surgery. A physical therapist will teach you how to exercise and walk. You will learn how to gradually increase the amount of weight you put on your artificial knee. Exercise is necessary to strengthen your leg muscles not only to walk but also to help stabilize your prosthesis. It is a good idea to take your pain medication before you first start your physical therapy exercises.
After you go home you should continue exercising to strengthen and improve the range of motion of your new knee. Although you should be able to get back to light work (such as a desk job) in about a month, it may take longer (3 or 4 months) to start doing more active work. Don't engage in strenous activities like jogging, running, or active sports. Avoid twisting your knee - if you have to turn while standing, do so by stepping with your feet and not simply by turning at the waist. Take care of your prosthesis and it should last you for many years.
Call Us If ...
If you have any of the following, CALL US (Union office: 908-964-6600, Bayonne office: 201-858-1500):
• Fever over 101 º F
• sudden shortness of breath or chest pain
• increase in knee pain
• excessive warmth, redness, or discharge from the incision site
• swelling or pain of the calf or leg
1000 Galloping Hill Rd
#202, Union, NJ 07083
Tel: 908 964-6600
Fax: 908 364-1025
Bayonne, NJ 07002
Tel: 201 858-1500